Western NY Center for Real Estate, Research & Economic Development
Grant Application
PROGRAM: ________________________________Home Inspection Licensing Program________________________________
Instructions: Complete this form in its entirety and forward to the Educational Coordinator, Western NY school of Real Estate,
2304 Wehrle Dr., Williamsville NY 14221 Phone: (716) 633‐9009 (must be original signature no faxes allowed).
YOUR COMPLETE NAME:
STREET ADDRESS:
CITY, STATE, ZIP CODE:
PHONE NUMBERS:
High School & Year Completed: College, Degree & Year Completed: FINANCIAL INFORMATION (Please answer all questions)
Are you currently employed:
Full‐time Part‐time Unemployed Student Other: ________________________________
Employers Name:
Years on the job:
Your Email address (print clearly): YOUR COMPLETE SOCIAL SECURITY NUMBER: _______________________________
Grant Requirements:
In conjunction with the above referenced school, the grant for training will be given to qualified applicants for up to a maximum lifetime benefit of one-thousand
dollars per person for tuition only. Applicants are responsible for any textbook or additional fees required by the school. A complete breakdown of costs will be
provided to you in advance of your acceptance of the grant should you be awarded so. If you are awarded a grant, you will be responsible for any state or
federal income taxes applicable (a 1099 will be issued to you by Feb 1st following the year the grant was made). The grant will be paid to the school directly (as
a credit) toward your tuition fee – no portion of it will be paid to you directly or refunded should you drop out of the licensing program (or fail to complete it for
any reason). If you drop out of the program or change your mind, there will be no refund of any money you paid or any portion of the grant awarded. There are
no exceptions to this refund policy and this supercedes any refund sections provided for in any other contract you sign at the school. There will be no financial
penalty assessed should you drop out either. Grant applications received after the start of the program are not retroactive, they must be received prior to the
start of the first day of class. You have up to 2 years to complete the program, otherwise any fees paid will be lost and any time spent will be invalidated
(unless you complete a specific module, then you will be awarded credit for such module accordingly). Since this is part of a NY State licensing series, please
do not submit an application for a grant if you have ever been convicted of a misdemeanor or felony anywhere in this state or elsewhere.
Applicants that receive a grant will have to sign up and pay the difference for the entire program and all 140 or 170 hours of education. You cannot sign up for
individual modules and apply any grant money. For example, if you accept the grant then sign up for the entire program (and you are awarded the maximum
amount), the math would be as follows: $2,695 - $1,000 (grant) = $1,695 plus textbook ($106.95 + sales tax) = $1,811.30 due from applicant. Individuals
awarded a grant in any amount are ineligible to receive tools unless they wish to forfeit their grant. If you receive a grant, tools will not be included by the
school. Grant recipients cannot start until full payment is made to the School in the form of cash, check or money order only. As part of the grant application,
all applicants must include a written statement explaining how or why he or she feels they would contribute to the field of home inspection. Missed sessions
after you start can be made up for $30 each or for no fee when the program is offered again. You will be notified by email of the status of your application
within 10 business days. I certify that the information provided herein is accurate and complete. I also understand the financial consequences should I
later change my mind if I am awarded a grant. I know that I am not under any obligation whatsoever by submitting this grant
application and that incomplete applications will not be processed.
______________________________ ____________
Applicant Name (printed)
Date
______________________________
Applicant Signature